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Longitudinal Study of Music Therapy's Effectiveness for Premature Infants and Their Caregivers

Not Applicable
Completed
Conditions
Preterm Birth
Interventions
Behavioral: MT during NICU
Other: Standard care
Behavioral: MT after NICU
Registration Number
NCT03564184
Lead Sponsor
NORCE Norwegian Research Centre AS
Brief Summary

Background: Preterm birth has major medical, psychological and socio-economic consequences worldwide. A recent systematic review suggests positive effects of music therapy (MT) on physiological measures of preterm infants and maternal anxiety, but methodologically rigorous studies including long-term follow-up of infant and parental outcomes are missing. Drawing upon caregivers' inherent resources, this study emphasizes caregiver involvement in MT to promote attuned, developmentally-appropriate musical interactions that may be of mutual benefit to infant and parent. This study will determine whether MT, as delivered by a qualified music therapist during neonatal intensive care unit (NICU) hospitalization and/or in home/municipal settings following discharge, is superior to standard care in improving bonding between primary caregivers and preterm infants, parent well-being and infant development.

Methods: Design: International multi-center, assessor-blind, 2x2 factorial, pragmatic randomized controlled trial. A feasibility study has been completed; ethical approval for the main trial is pending. Participants: 250 preterm infants and their parents. Intervention: MT focusing on singing specifically tailored to infant responses, will be delivered during NICU and/or during a post-discharge 6-month period. Primary outcome: Changes in mother-infant bonding until 6 months corrected age (CA), as measured by the Postpartum Bonding Questionnaire. Secondary outcomes: Mother-infant bonding at discharge and over 12 months CA; child development over 24 months; and parental depression, anxiety, and stress, and infant re-hospitalization, all over 12 months.

Discussion: This study fills a gap by measuring the long-term impact of MT for preterm infants/caregivers, and of MT beyond the hospital context. Outcomes related to highly involving parents in MT will directly inform the development of clinical practice in Scandinavia and other contexts with similar social welfare practices. By incorporating family-centered care, continuity of care, user involvement, and cultural relevance, this study can potentially contribute to improved quality of care for premature infants and their parents worldwide.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
213
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
MT during NICUStandard careConsists of music therapy during NICU hospitalization, along with standard care.
MT during and after NICUStandard careConsists of music therapy during NICU hospitalization, and music therapy after discharge from initial NICU hospitalization, along with standard care.
MT during NICUMT during NICUConsists of music therapy during NICU hospitalization, along with standard care.
No MTStandard careConsists of standard care.
MT during and after NICUMT during NICUConsists of music therapy during NICU hospitalization, and music therapy after discharge from initial NICU hospitalization, along with standard care.
MT during and after NICUMT after NICUConsists of music therapy during NICU hospitalization, and music therapy after discharge from initial NICU hospitalization, along with standard care.
MT after NICUMT after NICUConsists of music therapy after discharge from initial NICU hospitalization, along with standard care.
MT after NICUStandard careConsists of music therapy after discharge from initial NICU hospitalization, along with standard care.
Primary Outcome Measures
NameTimeMethod
Bonding between primary caregiver and infant6 months

Total score of the Postpartum Bonding Questionnaire (PBQ), a parent-rated screening instrument for disorders of the early mother-infant relationship consisting of 25 statements on a six-point Likert scale (each 0-5; sum score ranging from 0 to 125; high = problematic).

Secondary Outcome Measures
NameTimeMethod
Infant development12 months

Ages and Stages Questionnaire, 3rd edition (ASQ-3), an age-specific parent-reported screening questionnaire consisting of 30 items, total sum score ranging from 0 to 300, with higher scores indicating better development.

Bonding between primary caregiver and infant12 months

Total score of the Postpartum Bonding Questionnaire (PBQ), a parent-rated screening instrument for disorders of the early mother-infant relationship consisting of 25 statements on a six-point Likert scale (each 0-5; sum score ranging from 0 to 125; high = problematic).

Infant socio-emotional development12 months

Ages and Stages Questionnaire Social-Emotional (ASQ:SE), a parent-completed questionnaire with 19 or 22 Likert-scaled items (each 0-5-10), plus additional items for whether an item is of concern to the parent (each 0-5), resulting in a score ranging from 0-285 or 0-300, at 6 and 12 months respectively. Lower scores indicate better socio-emotional development.

Parental stress12 months

Parental Stress Scale (PSS), a self-report 18-item questionnaire that assesses stress associated with parenting. Sum scores can range from 18 to 90, with higher scores indicating higher stress.

Parental anxiety12 months

Generalized Anxiety Disorder Assessment (GAD-7), a self-report 7-item questionnaire serving as a screening tool and severity measure for generalized anxiety disorder. Sum scores can range from 0 to 21, with higher scores indicating higher anxiety.

Child development24 months

Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III), standardized with a population mean of 100 (SD 15), with higher scores indicating better development

Re-hospitalization12 months

Re-hospitalization excluding outpatient visits, based on electronic health records. This will be calculated as the time from initial discharge until first re-hospitalization.

Maternal depression12 months

Edinburgh Postnatal Depression Scale (EPDS), a 10-item validated self-report instrument assessing mothers' postpartum depressive symptoms, excluding somatic symptoms of depression that are common in new mothers (such as loss of energy, feeling tired, changes in appetite and sexual drive). Sum scores can range from 0 to 30, with high scores indicating more depressive symptoms.

Trial Locations

Locations (10)

Hospital Materno Infantil Ramón Sardá

🇦🇷

Buenos Aires, Caba, Argentina

Sanatorio Mater Dei

🇦🇷

Buenos Aires, Caba, Argentina

Clinica de la Mujer

🇨🇴

Bogotá, Colombia

Hospital Fernandez

🇦🇷

Buenos Aires, Argentina

Fundación Santa Fe de Bogotá

🇨🇴

Bogotá, Colombia

Haukeland University Hospital, Barne-og ungdomsklinikken

🇳🇴

Bergen, Hordaland, Norway

Akershus University Hospital

🇳🇴

Oslo, Lørenskog, Norway

Meir Medical Center

🇮🇱

Kfar Saba, Israel

Oslo University Hospital, Rikshospitalet

🇳🇴

Oslo, Norway

Szpital Miejski w Rudzie Śląskiej

🇵🇱

Ruda Śląska, Poland

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